Wh Change Scienc
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Copyright © 2019 by Catherine Whitlock and Rhodri Evans
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First Diversion Books edition June 2019.
Hardcover ISBN: 978-1-63576-610-3
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First published in the United Kingdom by Robinson. Printed in the U.S.A.
Acknowledgements
Glossary
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About
FOREWORD
IT IS OVER A CENTURY since the first woman received a Nobel Prize in science. In that time, since 1911 when Marie Curie received that accolade, only a further eighteen women have been likewise so honored (including Marie Curie who won it twice) and only a single woman in the UK has been so honored. When she was—Dorothy Hodgkin in 1964—did the press regard her in the same light as they would a man in the same position? Absolutely not. The Daily Telegraph announced “British woman wins Nobel Prize— £18,750 prize to mother of three.” The Daily Mail was even briefer in its headline “Oxford housewife wins Nobel.” The Observer commented in its write-up “affable-looking housewife Mrs. Hodgkin” had won the prize “for a thoroughly unhousewifely skill: the structure of crystals of great chemical interest.” It makes for depressing reading fifty years later, but we have nothing more up to date to leaven the message. Two more women winning prizes in 2018 is a step in the right direction, but hardly proof that the situation is transformed. Dorothy Hodgkin, featured as one of the ten outstanding women who have contributed so much to the world of science in this book, would not have had time to consider whether or not she was a feminist (although in later life she was very visibly a pacifist). She only wanted to get on with the job of what really interested her: the structure of biological molecules. As she put it, she just wanted to “live simply and do serious things,” and serious things she most certainly did, solving the three-dimensional structures of insulin, vitamin B12, and penicillin amongst other complex molecules. As a woman working in a man’s world, she simply dedicated herself to achieving as much as she could and small matters like pregnancy were not allowed to get in the way. When married, but still working under her maiden name of Crowfoot, she presented a key paper at a major meeting at the Royal Society in 1938 when eight months
pregnant. A long-term collaborator (and another Nobel Prize winner), Max Perutz, referred to her appearance at this meeting in his speech at her memorial service: “Dorothy lectured in that state as if it were the most natural thing in the world, without any pretense of trying to be unconventional, which it certainly was at the time.”
In this book, her life and those of nine other remarkable women, including Marie Curie, are explored—women from around the world and from very different cultures and backgrounds. It is interesting to see what common features their lives share and what that might mean for young women growing up now. At the top level of sciences, particularly the physical sciences, there is still a dire paucity of women. Diversity—amongst Nobel Prize winners in particular, but also amongst the movers and shakers (and winners) in science—is still rather limited. The women chosen for this book are all dead, not living role models who might be seen on TV or interviewed in the press (let alone liked on social media): the authors felt that that distance provides perspective and understanding.
In the days before superfast global communication, these women’s science and the impact they made often remained hidden and to a certain extent unrecognized, sometimes by their peers and almost invariably by the general public. Even in today’s era of highly accessible information, their importance and impact are not well known. They and their work should be better appreciated because they were groundbreaking trailblazers, whether or not they would have recognized that at the time.
Luck plays a role in every scientist’s life, whether or not they are prepared to admit it. In the case of Gertrude Elion it was her father’s suggestion that after repeatedly failing to get even as far as job interviews after obtaining her MS in chemistry—she ring up Burroughs Wellcome, simply because he was familiar with the company because they made a painkiller he used in his dental practice. There, Elion quickly found her feet and stayed for many years researching novel “designer drugs,” for which she ultimately won the Nobel Prize in 1988. The Chinese-American physicist Chien-
Shiung Wu said of her own work that “Relying purely on ingenuity, determination, and luck, three of us (an enthusiastic chemist, a dedicated student, and myself) worked together uninterruptedly to grow about ten large perfect translucent CMN single crystals by the end of three weeks.” Growing crystals of complex molecules is something of a black art, which is why luck enters into it. But she was also unlucky in that the Nobel Committee overlooked her strong credentials; she enters the group of women—to which Lise Meitner from this book also belongs—who are so often identified as those who did notwin a Nobel Prize when they were more than deserving. Here, lack of luck in the lottery of winning big prizes also enters into the dimension, along with the bias often attributed to the Swedish committee.
The determination Chien-Shiung Wu mentions is also a crucial character trait absolutely required for success for anyone in science. Determination is often epitomized by the hard work that Marie Curie, with her husband Pierre, put in to extract from the bulk mineral pitchblende the trace components of the elements ultimately known as thorium and polonium that give rise to high levels of radioactivity, levels she recognized as being much higher than that due to uranium alone. Marie Curie is of course the female scientist that most members of the public are likely to be able to name and the only woman accorded the honor of two Nobel Prizes, one in Physics and one in Chemistry.
Rachel Carson was another woman who exhibited enormous determination to bring her concerns about environmental pollution to the wider public, however much this steeliness may have been hidden behind a quiet exterior. Without this strength of mind coupled with beautiful writing skills, it is unlikely that the dangers associated with pesticides such as DDT would have been recognized—and acted upon—anything like as fast.
Above all else, though, scientists must harness their creativity and imagination. Research and discovery necessarily require a plunge into the unknown. If the answers were already known then there would not be any research to do. Not everyone is cut out to cope with such uncertainty and unfamiliarity, but the ten women
discussed here all possessed the curiosity and willingness to attack a blank sheet of paper with gusto and guts. The results they obtained changed the world of science, whether or not their names are familiar in our daily lives.
These women overcame all the many obstacles their gender placed in their way to produce breath-taking results of profound significance, work whose importance still echoes today. We should be grateful to these pioneers and, without sentimentalizing their lives, we should appreciate all they did to facilitate the female scientists who have followed in their footsteps. As the L’Oréal tagline puts it, “The world needs science and science needs women.” The lives of the ten women described here provide us with much food for thought and perhaps inspiration for the budding scientists of tomorrow.
AtheneDonald,
Professor of Experimental Physics, University of Cambridge, and Master of Churchill College
INTRODUCTION
“OXFORD HOUSEWIFE WINS NOBEL” would not pass muster as a politically correct headline these days. Notwithstanding the inherent sexism in the choice of words, receiving a Nobel Prize does not determine how successful a scientist you are, nor is it something many scientists set out to achieve. Certainly Dorothy Hodgkin, about whom the Daily Mail wrote that headline in 1964, was far too busy getting on with the job at hand—probing the structures of complex biological molecules—to be focused on either prizes or headlines. She did not see herself as a feminist or consider too deeply how she was defined. Dorothy was, in her own words, a woman who chose to “live simply and do serious things.” This was an understatement: she worked extremely hard at a subject about which she was passionate, enjoyed a long and sometimes demanding marriage, had three children, suffered from crippling rheumatoid arthritis, and played out a humanitarian role on the world stage.
All in a day’s work for Dorothy, so she was a natural choice for inclusion in this book. Others required a bit more consideration. Was it important to choose women who had children in order to suggest that women could have it all? Or was their science the most important thing about them? Delving into their family lives was only one facet of their story in science. And their scientific lives are, after all, the focus here.
In deciding on our ten, we chose women who are no longer alive. That was mainly because distance brings their achievements into focus. Many of these women were not well-known in their lifetime and, in the days before Google existed, finding out about them would have been harder. Nowadays, the news of the 2018 Nobel Prize winner in Physics, Donna Strickland—only the third awarded to a woman—was spread worldwide within seconds of its announcement. Only one of our choices, Marie Curie, is a household
name. We could have chosen to omit her, as she is so well known, but her work on radioactivity was vital, considerably advancing the field of nuclear physics, and she serves as a benchmark for others. Needless to say, the women in this book are more than a match for her.
It’s not easy to narrow down to a list of ten, even in the relatively small pool of influential female scientists. Ten seemed a good round number to pick—large enough to provide some breadth but small enough to allow depth, too. We have tried to introduce as much variety as possible, to provide a broad picture of the impact these pioneers have made. These women worked in very different areas of science: some lab-based and highly technical, others in medical science or in the environment. There is an international flavor here as well, with American, British, Chinese, Italian, and Polish scientists represented.
Not only did these women work in very different areas but they were very different characters, too, from the shy Lise Meitner and the retiring but persuasive Rachel Carson to the more outgoing, sociable Virginia Apgar and the strong-willed Rita Levi-Montalcini. It takes all sorts to be a successful scientist. That said, there are some common themes that run through their personalities, science, and lives.
All of these women were born within approximately fifty years of each other, with the majority born in the twelve years between 1906 and 1918. As the Victorian industrial age opened up a technological front, they lived through a period of great change, both in the scientific world and from a historical perspective. Two world wars, the financial deprivation of the Great Depression, and the Cold War made huge impacts on their lives and working conditions.
Working conditions were often very tough. The name of the game here was exile—from their countries (Lise Meitner), within their countries (Rita Levi-Montalcini), or “just” from the male-dominated environments of their era, including lecture halls or the facilities upstairs (Henrietta Leavitt). Where lab space was provided, it was often very cold (Marie Curie) or very hot (Gertrude Elion) or lacking in the most basic health-and-safety measures (Marie Curie and
Dorothy Hodgkin). Their work was frequently physically and/or mentally draining.
There were upsides. All of our scientists lived in an age where they didn’t have to justify their research in the same way as is required nowadays. No impact statements were necessary. Pure research was just that and they were often much freer to push the boundaries in whichever direction the research led.
Inspiration came frequently, initially in the form of family influence because the parents propagated an intellectual environment and/or because the older generation, particularly the mothers, felt that they had missed out on an education and a career. Family support—both moral and financial—was key, often into adulthood. The home environment and personal experiences also drove some of these women. Rachel Carson’s rural idyll and the threat from local industry permeated her later environmental research and writing, while the illness and death of close family and friends propelled Virginia Apgar, Rita Levi-Montalcini, and Gertrude Elion into medical research. Later in life, teachers, university lecturers, or close colleagues frequently provided the spark that ignited their interest.
Some characteristics are common to all these women: an early, insatiable appetite for learning; persistence—a certain terrier-like mentality; experimental precision; fierce intellectual focus; drive; and intuition. These threads are woven throughout their stories and undoubtedly contributed to their scientific success. It’s likely that none of these women would have set much store by analyzing the relative merits of these characteristics, nor were they self-publicists. They were too busy doing their science and many, such as Elsie Widdowson, reasoned that no one would be interested in their story. Only one, Rita Levi-Montalcini, wrote an autobiography, wryly titled In Praise of Imperfection, and that was, in part, achieved because she lived until she was 103 years old!
Many of these women had a very personal approach to science, sometimes at odds with the formal attitudes of their time. Dorothy Hodgkin insisted that everyone in her lab was called by their first names, something that we have adopted for the women in this book. And Dorothy, like Marie and Rita, was not averse to, and
indeed encouraged, positive discrimination in her laboratory. Passing on knowledge is a constant theme, too, with scientists like Virginia and Gertrude consistently praised for their teaching capabilities and a warm, engaging approach to their students.
It’s easy to slip into hagiography when discussing these women but they certainly weren’t saints. Chien-Shiung Wu was frequently described as a “slave driver” by her laboratory staff and her parenting skills were questionable at times. Rita Levi-Montalcini was not known for suffering fools gladly and her argumentative nature frequently got her into trouble. But the facts speak for themselves. These were ordinary women who, often via rather circuitous routes and not without their fair share of mishaps, disasters, and family tragedies, did extraordinary things.
A significant number of our scientists had such strong working partnerships that they were married to a particular colleague in their science, and in life in the case of Marie and Pierre Curie. For most, a shared passion did not necessarily extend beyond the laboratory, but some scientific partnerships were so successful that they remained close collaborators for many years, sixty in the case of Elsie Widdowson and Robert McCance. Lise Meitner and Otto Hahn’s story was of a more tortuous, unbalanced relationship but, despite this, their joint scientific legacy has stood the test of time. Gertrude Elion and George Hitchings shared an ability to develop a personal relationship with their cancer patients and design radically different drug treatments. Rita Levi-Montalcini and Viktor Hamburger were also equally involved in their science, but partnerships like theirs often encompassed quite different mindsets; Viktor’s incremental approach to scientific research complemented Rita’s more flamboyant style.
The social context of science is important, and none realized this more acutely than Lise Meitner when she discovered that her research was going to be used to make an atomic bomb. Women like Lise Meitner and Marie Curie were brilliant scientists but they were outsiders, let in reluctantly, often working beyond the walls of the establishment. That put them in a strong position to question and address those issues that others toeing the line could not. Their
viewpoint and experience were different. They were open to questioning the processes. Where was the science leading and were the scientists involved guiding that process effectively?
Dorothy Hodgkin was a lifelong promoter of science nationally and internationally. At a time when the Cold War, and the rise of communism, was influencing and hampering scientific research in countries such as China and Russia, she built scientific relationships and kept the lines of communication open. She shared this humanitarian streak with others. Lise Meitner, Marie Curie, and Rita Levi-Montalcini worked to help the sick in the two world wars, frequently in distressing and humbling conditions and often using their scientific backgrounds. Rita Levi-Montalcini continued throughout her long life to promote the cause of women, in particular women’s education.
Science doesn’t work in a vacuum and engaging the public is vital. Many of our ten women were aware of the public interest in science and were keen to reach out to others. Rachel Carson’s views sum it up well: “We live in a scientific age; yet we assume that knowledge of science is the prerogative of only a small number of human beings, isolated and priest-like in their laboratories. This is not true. The materials of science are the material of life itself. Science is part of the reality of living; it is the what, the how, and the why of everything in our experience.”
In an ideal world, a book like this would simply illuminate what interesting scientific lives these women led and any push to correct the gender imbalance and inspire young scientists, particularly women, would fade into the background. For now, we hope that by turning a spotlight on these ten women’s experiences of science, and the differences they made to the world, this book will serve as a reminder of what is possible for women in science, with determination, direction, and focus.
Granger, NYC/Topfoto
Newborn babies the world over owe their lives to Virginia Apgar and her approach to life, summed up by one of her colleagues as, “Do what is right and do it now.” Virginia was a trailblazer for modern women in medicine, qualifying in the United States in 1933, when only 5 percent of doctors were women. She helped to develop the new field of obstetric anesthetics and her interest in the health of newborn babies resulted in the Apgar test: five simple and quick assessments that can be life-saving and are now used worldwide. The Apgar test laid the foundation for the field of neonatology and Virginia went on to become a world leader in the prevention of birth defects, raising awareness and much-needed funds for research.
Alongside her groundbreaking medical work, Virginia found time for many hobbies, in particular music. She was an energetic, determined, and charismatic woman who was undeterred by the chauvinistic nature of medicine and the financial hardships of her early training. Proclaiming that “women are liberated from the time they leave the womb,” Virginia was more than willing to share her joie de vivre and her achievements with others.
Virginia Apgar was born in Westfield, New Jersey on June 7, 1909. The family was delighted to welcome a girl into the family, following the birth of two older brothers, Charles and Lawrence. The Apgar household was a happy, productive, and enterprising one. Virginia once said that she came from a family that “never sat down,” a trait that she inherited.
Her father, also named Charles, was a salesman for the New York Life Insurance Company but his real love was science and inventions. He provided an inquiring and creative environment for the young Virginia, sometimes with surprising consequences. Charles was a radio ham and during the First World War he helped to decode messages to German U-boats that were targeting Allied shipping in the Atlantic, and ships were saved.
Creativity was very evident, too, in the form of music, another of Charles’s hobbies. The family often held amateur concerts in their living room and both Virginia and her brother Lawrence had music lessons from an early age; Virginia started on the violin at six years old and later the cello, while Lawrence learned the piano. When the children were old enough, they started performing in front-room concerts and at recitals in local concert halls. Lawrence eventually became a professor of music in Oxford, Ohio.
Virginia’s childhood was not entirely free from tragedy. Her eldest brother, Charles Jr., died of tuberculosis just before his fourth birthday, a common occurrence in the 1900s when most of the population was infected and before the advent of antibiotics. Lawrence was two years older than Virginia and suffered from chronic eczema. Like many of her generation, her mother Helen’s
sole focus was her family, particularly as Lawrence’s eczema required much time and effort to keep under control.
Her mother’s preoccupation with Lawrence meant that Virginia and her father were able to develop their shared interest in science. It’s not clear precisely when or why Virginia decided to become a doctor, but her elder brother’s premature death, her father’s scientific interests, and her mother’s caring nature may all have been factors in her decision.
Virginia’s drive to achieve academically was helped by her natural intelligence and her affinity for subjects like mathematics and Greek. At school, she loved debating and was a member of the high-school debating society for four years. With her tall and slim stature, Virginia was a natural athlete and enjoyed tennis and basketball as well. She continued to pursue her interest in music and was a keen member of the school orchestra. Virginia’s prodigious energy and involvement in all aspects of school life is reflected in her high-school yearbook, where her entry ends with the question, “Frankly how does she do it?”
Getting a college degree, let alone in medicine, was not commonplace for girls when Virginia graduated from high school. Yet she was determined to pursue her interests in science and medicine and, in 1925, at the tender age of sixteen, Virginia enrolled at Mount Holyoke College in South Hadley, Massachusetts. There she majored in zoology with chemistry and continued to have an active extracurricular life, too, playing the violin and cello in the campus orchestra and acting in several plays. She was affectionately known to her peers as “Jimmy,” the girl who did it all. Writing home, unaware of the use of words that would highlight her future work, she reported to her parents, “I’m very well and happy but I haven’t one minute even to breathe.” In 1929, she graduated and set her sights on the next goal—a medical degree.
The timing was not good. In August 1929, the United States economy went into recession, swiftly followed by the stock market crash of October 1929. With the onset of the Great Depression, money was tight for many people and Virginia’s family was no exception. Virginia took several odd jobs to support herself, including
one in the laboratory of the zoology department at Mount Holyoke College. This proved to be an unorthodox occupation by today’s standards as her main task was to catch stray cats for the lab, which were humanely killed and preserved for classwork dissections.
With the help of scholarships, the money she earned, and some she borrowed, Virginia started at Columbia University’s College of Physicians and Surgeons in 1929, at the age of twenty, one of three women in a group of sixty-nine. A fellow medical student, Vera Joseph, who also had to struggle with racial discrimination, remembered her well: “In her keen, perceptive way, she recognized my need for assurance . . . she would pause for a cheerful greeting, a reassuring hug or a conversation.”
Four years later, in 1933, Virginia graduated fourth in her class and took a surgical post at Columbia Presbyterian Hospital to complete the next stage of her medical training. She impressed her superiors with her skill and intellect but the head of the surgical department, Dr. Allen Whipple, dissuaded her from pursuing a career in surgery. He thought that the shortage of posts, particularly for women in the Great Depression, meant that she would struggle to establish herself. And there were the debts she had incurred in her training to consider—almost $4,000—a vast sum, equivalent to over $70,000 today.
With these factors in mind, Whipple was supportive of Virginia’s desire to pursue a medical career and suggested anesthetics as an alternative field. He admired her abilities and spotted the need for training in this new field. In the period 1920–48, no more than 5 percent of doctors in the United States were women but in anesthetics approximately 12 percent were. Other mentors may well have given female doctors advice similar to that of Whipple or perhaps the high percentage was simply because historically anesthesia had been performed by female nurses.
Anesthetics was nothing like as advanced as it is today. Although a small number of doctors practiced as anesthetists in the UK in the 1930s, few were specialists in the United States and nurses had been fulfilling this role since the 1880s. Nowadays, “anesthetists” are nurses (though they are doctors in the UK) and doctors in this field
are called “anesthesiologists.” In the 1930s, nurses were often highly competent and technically skilled, but many American academic surgeons were concerned about the future of surgery. Surgical procedures were becoming increasingly complex, requiring the development of better anesthetics, and Whipple suggested that Virginia could make a significant contribution to that field.
In 1934, aged twenty-five, Virginia began her search for a training position, writing to the headquarters of the Associated Anesthetists of the United States and Canada. Their response revealed a problem: only thirteen training posts were available and only two of these were paid positions. After finishing her surgical post in 1935, Virginia reasoned that it would be better to stay put and learn the fundamentals of anesthetics from the nurses at Columbia Presbyterian Hospital. In 1937, she spent six months with Dr. Ralph Waters in Madison, Wisconsin. He had set up the first academic anesthetic department in the United States in 1927 and was leading the way in anesthetic practices.
It was a period of intense learning for Virginia but not an easy one socially. The only woman in her class, she was accepted during the working day, but excluded from dinners and other social events in the evening. Medicine was very much a man’s world, exemplified by the lack of housing for female doctors; in her six months in Madison she moved three times. Her housing problem continued when she returned to New York, this time to work with Dr. Emery Rovenstine at Bellevue Hospital. Here, she lodged temporarily in the maids’ quarters of the clinic.
Undeterred, Virginia finished her anesthetics training at Bellevue in 1938 and returned to Columbia Presbyterian Hospital. In 1939, aged thirty, she became the second female member of the American Society of Anesthetists and the fiftieth American doctor to be a board-certified anesthetist. Soon after, she was elected as its new leader and became the first woman to head the Division of Anesthesia at the hospital. She set up an organizational structure, establishing residences and incorporated new specialists, without displacing the nurses who had kept the field of anesthetics alive.
As Virginia’s department grew over the next ten years, she expanded her knowledge of anesthetics, branching out into the new field of obstetric anesthetics. Her work was now focused on the arrival of new life, but death was also close at hand. In 1950, when she was forty-one, her beloved father died, aged eighty-five; although she mourned his loss, she was grateful that he had witnessed her success as a female doctor. By 1955, that success led to her appointment as the head of the obstetric anesthesia department at Columbia Presbyterian Hospital.
Her father’s influence continued after his death. Virginia’s interest in music stemmed from him and, as an adult, even though Virginia was very absorbed in her medical work, she played cello and viola regularly in the Teaneck Symphony of New York and the Amateur Music Players. Her cello and/or viola even accompanied her on her travels, so she could practice and play with local chamber music groups when her busy schedule allowed it.
Not content with just playing her instruments, in 1956 Virginia embarked on another musical odyssey—making her own instruments. She was inspired to do so after meeting a patient, Carleen Hutchings, a fellow music enthusiast who started teaching Virginia all she knew about constructing musical instruments. It wasn’t easy finding the time and it wasn’t always a quiet occupation either. Virginia’s neighbors were kept awake into the early hours as she hammered away in her bedroom, now filled with woodworking tools and her workbench. Virginia’s dedication to her new craft resulted in a violin, a mezzo violin, a cello, and a viola.
Virginia had a dedicated approach to all her activities, whether it was pursuing her medical career and her focus on the care of newborn babies or in her hobbies. Keeping active was important to Virginia. At school she had played team sports like basketball and later in life she developed a love of golf, angling, and gardening. She also enjoyed watching baseball and was a committed fan of the Brooklyn Dodgers.
Virginia’s lifelong love of learning, whether it was making musical instruments, learning a new sport, or pursing her interests in science and medicine, was often commented on. One of her mentors and
good friend, Dr. L. Stanley James, described her as “a student until the day she died. Learning was the focal point of her life. Her curiosity was insatiable and new knowledge held a continuing fascination for her. She was always ready to accept new information and to modify or change her ideas accordingly. She never became rigid. This rare quality enabled her to progress through life without becoming walled in by tradition or custom.”
Her dedication and problem-solving approach to her instrumentmaking matched her approach to her medical work. Ingenuity was never far from the surface in Virginia’s life and the newborn screening test that carries her name, the Apgar test, was equally ingenious in its simplicity and effectiveness.
As Virginia developed her interest and skill in anesthetics between 1939 and 1949, she was drawn to its applications in obstetric medicine. According to Dr. Selma Calmes, a leading anesthetist, Virginia entered this field “in the right time and the right place.” It was not common in the 1940s to be anesthetized when giving birth, but Virginia’s new job involved her in the process of Caesarean delivery. This did require anesthetic, the application of which was not well understood—in its effect on either the mother or the baby—and resulted in unacceptably high maternal mortality during or just after birth.
Virginia’s flexibility and openness to new developments—which extended to her own ability to admit mistakes when they occurred— were instrumental in moving the discipline of anesthetics forward. New anesthetics were being developed and Virginia made numerous careful observations of how they affected both the mother and the newborn baby. Between 1949 and 1952, she gathered data on the early moments of a newborn’s life, health, and prognoses.
Virginia’s powers of clinical observation and her ability to make important changes in obstetric anesthetics, and disseminate that knowledge, did not go unnoticed. One of her colleagues, Dr. Stanley James, later said, “Virginia was not just a doctor. She was also an educator.” As obstetric anesthetics was such a new field, there was not much published material but Virginia was pragmatic by nature and improvised with what teaching aids were available: she used old
bones, or even her own pelvic bone which had an unusual shape, shocking one Australian doctor who had heard about Dr. Apgar’s pelvis and presumed it belonged to the old and much used skeleton.
The feature of delivery rooms that struck Virginia so forcibly in the late 1940s and early 1950s was the care of babies just after they were born. The focus was more on the mother’s well-being than the baby’s. Hospital deliveries were replacing home births, which meant that more mothers and babies were surviving the birth process, but the first twenty-four hours of a baby’s life were still an uncertain time.
There was no routine examination of the newborns’ vital signs and, if there was, the methods varied from hospital to hospital and were often unscientific, and even unsafe. Doctors were missing signs that a baby was, for example, starved of oxygen, a factor in half of newborn deaths. Some doctors assumed that babies that were underweight or struggling to breathe should be left to die. “It was considered better not to be aggressive. You dried them, you shook them and some doctors patted them on the backside and that was it,” said Professor Alan Fleischman, professor of pediatrics at the Albert Einstein College of Medicine in New York.
There was a dire need for a system that checked vital signs, such as heartbeat and breathing rate, from the minute a baby was born. That way, the appropriate special care could be put into place before it was too late.
Virginia’s eureka moment occurred one morning while she was having breakfast in the hospital canteen. One of her medical students asked her how to evaluate newborn babies’ well-being. Virginia replied, “That’s easy. You would do it like this,” and jotted down the five vital signs to look for. Initially called the Newborn Screening System, it was the first version of what became the Apgar test.
The medical student may have been surprised by the seemingly instantaneous production of a new scoring system, but Virginia’s thoughts were the result of her many years of painstaking observations and clinical knowledge. As a practicing anesthetist, Virginia’s daily work involved close contact with newborns. She had
seen seemingly healthy babies being whisked away from their mothers to be weighed and measured, only to turn blue and struggle to breathe.
Virginia understood the importance of checking the five vital signs at one minute after birth. Each of these is given a score of zero, one, or two. A total score of seven to ten is considered normal, while four to six necessitates some intervention to stimulate, for example breathing, and a score below three leads to emergency treatment. Few babies get a perfect ten one minute after birth, as the circulation—oxygenated blood—often hasn’t reached the fingers and toes fully, so these can still be blue.
As the Apgar score became more widely used, it was clear that having a second set of measurements would reveal how the baby was thriving after being born. Comparisons between scores taken at different times would enable the healthcare professionals to monitor improvement or deterioration. Now, the Apgar test is routinely performed at one and five minutes after birth. If necessary, it can be repeated at ten minutes.
After testing the scoring system on more than a thousand newborns, Virginia’s test was presented at a meeting in 1952 and, in 1953, Virginia published her findings. The sole-author publication, in CurrentResearchesinAnesthesiaandAnalgesia,detailed the score’s value as a predictor of newborn survival. This is a rare example of a universally accepted and applauded test that was quickly and routinely applied. On the back of the wave of optimism following the advent of antibiotics, the world of medicine was ready for new advances.
Ten years later, in 1963, the newborn screening test was officially designated the Apgar test, when Dr. Joseph Butterfield at the Children’s Hospital in Denver suggested an acronym using Virginia’s surname to help users remember what to look for: Appearance, Pulse, Grimace, Activity, and Respiration. When he wrote to Virginia about it, she replied, “I chortled aloud when I saw the epigram. It is very clever and certainly original.” Dr. Joseph Butterfield published this acronym in the JournaloftheAmericanMedicalAssociation:
A is for Appearance. A normal pink skin color all over scores two. If the color is normal on the body but blue on the feet and/or hands, the score is one. A blue or very pale body is zero.
P is for Pulse. A newborn baby’s pulse (heart rate) should be over 100 beats per minute, denoting a score of two. Less than 100 beats per minute is one. If the pulse is absent, the score is zero.
G is for Grimace. This tests for reflexes after stimulating the soles of a baby’s feet. If a tickle or gentle slap elicits a jerking movement of the legs or a cough/sneeze, the score is two. A grimace scores one and no reaction zero.
A is for Activity. Muscle tone is indicated by free and regular movement of the arms and legs, scoring two. If the arms or legs are flexed, the score is one. Lack of movement scores zero.
R is for Respiration. If the baby cries and is breathing well after birth, this scores two. If the breathing is slow or labored, the score is one. Absence of breathing is zero.
APGAR SCALE (EVALUATE AT 1 AND 5 MINUTES POSTPARTUM)
Sign 2 1 0
A Activity (muscle tone) Active Arms and legs flexed Absent
P Pulse >100 bpm <100 bpm Absent
G Grimace (reflex irritability) Sneezes, coughs, pulls away Grimaces No response
A Appearance (skin color)
Normal over entire body
R Respiration
Normal except extremities
Cyanotic or pale all over
Good, crying Slow, irregular Absent
It’s easy to see that a high score, with mostly twos, indicates a thriving baby. If the score is mainly ones, some intervention is required, such as extra oxygen. Performing the test again at five minutes after birth then allows doctors to see whether that intervention has made a difference.
Improving interventions, such as the resuscitation of newborn babies if they were not breathing on their own, became a focus for Virginia. Ever aware of the baby’s needs, she helped start a revolution in resuscitation strategies. By using less-invasive ventilation and fewer drugs, according to Dr. Richard Polin, professor of pediatrics at Columbia Presbyterian Children’s Hospital of New York, these improved methods have led to the reduction of chronic lung disease in newborns.
Virginia’s life-saving skills were now reaching the wider public and even celebrities. In the winter of 1958, her university magazine, the MountHolyokeAlumnaeQuarterly, excitedly reported:
You never know where ’29 [the year Virginia graduated] will turn up next. An Associated Press story last August quoted showman Mike Todd as giving special credit to our Jimmy [a nickname from medical student days] Apgar for her work in saving the life of the premature baby born to his wife, Liz Taylor, screen star. Todd said Dr. Virginia Apgar “worked over the baby for 14 minutes before she hollered. Those were the longest 14 minutes of my life.” . . . She breathed life into the tiny infant.
Keeping people alive was paramount—newborn or adult—and Virginia would entertain friends with resuscitation stories. She always carried a pen knife, an airway tube, and bandages in her handbag, just in case she had to perform an emergency tracheostomy. This is an opening created at the front of the neck so a tube can be inserted into the windpipe (trachea) to bypass an obstruction and help someone breathe. She once said that she had performed this procedure on sixteen victims of car crashes, saying, “Nobody, but nobody, is going to stop breathing on me.”
Public health statistical models were changing and, as the Apgar test was rolled out across the United States, it became the gold standard for measuring a newborn’s well-being. Virginia expanded her research to look at the effect of labor, delivery, anesthetics, and oxygen deprival on the condition of newborn babies. Virginia’s colleagues, including Dr. Stanley James, helped her with the latest specialist knowledge of cardiology and new methods of measuring levels of oxygen and anesthetic.
Together the team demonstrated that babies with low levels of blood oxygen and highly acidic blood had low Apgar scores. Lower scores were also associated with certain methods of delivery, types of anesthetic given to the mother, and newborns deprived of oxygen. Virginia noticed that the administration of one anesthetic, cyclopropane, to the mother hampered her baby’s breathing after birth. This led to the removal of this anesthetic from the delivery room and the development of epidurals, local anesthetics that allow women to remain conscious and communicating while giving birth.
The Apgar score was a vital and informative result for one baby; now the cumulative data on thousands of babies revealed some important correlations. Before this simple but efficient scoring system had been invented, doctors, if they had noticed the correlations, did not have sufficient data to prove them. The Collaborative Project, a twelve-institution study involving 17,221 babies, established that the Apgar test, particularly the five-minute score, can predict neonatal survival and neurological development. As the Apgar test was more commonly used, babies who needed care started to get it, leading to the development of special-care
baby units and newborn-sized heartrate monitors and resuscitation aids.
In 1959, after twenty-six years of dedicated work as a doctor, Virginia decided to take a sabbatical. Although she had a break from the busy life of a medic, she was still focused on helping others, particularly as the Apgar test had stimulated research into the diagnosis and treatment of babies who were born with problems. There was plenty of data emerging on Apgar scores, and their relationship with newborns’ health, and Virginia was driven by a desire to pursue this. At the age of fifty, she returned to education and studied for a master’s degree in public health at the Johns Hopkins University in Baltimore. This facilitated a change in career direction, into the area of birth defects. Virginia had seen many babies born with these, often reflected in low Apgar scores at birth, and wanted to see how she could improve their immediate and more long-term care.
In January 1938, the National Foundation for Infantile Paralysis had been set up, principally to help children with polio. At the time there was no vaccine and over 50,000 people a year in the United States were paralyzed or died from polio virus infection. President Franklin Roosevelt (president in 1933–45) was a polio sufferer, often confined to a wheelchair, and he helped to start the organization. It later became known as the March of Dimes, a pun based on the newsreel “The March of Time” and coined by the comedian Eddie Cantor, who was involved in fundraising.
Cantor suggested that, “The March of Dimes will enable all persons, even the children, to show our president that they are with him in this battle against this disease. Nearly everyone can send in a dime, or several dimes. However, it takes only ten dimes to make a dollar and if a million people send only one dime, the total will be $100,000.” It grabbed the American public’s attention and, a month after the launch of the first appeal, 2,680,000 dimes, or $268,000, had been donated to combat polio.
After providing funds for the successful development of a polio vaccine by Dr. Jonas Salk, the organization now focused its efforts on fundraising for research into birth defects, the causes and prevention
of prematurity, and providing information for parents and the general public. Recent campaigns have included: more effective genetic screening, prevention of spina bifida through folic acid supplementation, and fighting the rising incidence of premature births.
When Virginia gained her MS in public health in 1959, she joined the March of Dimes and worked with the organization for fifteen years. Very quickly she became more than just a member, as she was made director of the Division of Congenital Malformations. She had decades of experience and her empathetic manner made her a natural choice for the post. Eight years later she became director of Basic Research and by 1973, at the age of sixty-four, she was senior vice president for Medical Affairs.
Virginia was involved in every aspect of the organization from fundraising to the promotion of health campaigns. Under her stewardship, the March of Dimes grew from a small group to a nationwide organization, largely due to the amount of money she raised; the organization doubled its income while she was involved. She felt strongly that her outreach work should focus on reducing the stigma of birth defects and increasing public awareness of the different types of birth defects. Before Virginia’s time, parents were encouraged to take babies with birth defects to institutions and relinquish all responsibility for them—an appalling prospect by today’s standards but the accepted thinking then was out of sight, out of mind.
The new field of perinatology was growing. This subspecialty of obstetrics is concerned with the care of the fetus and complicated high-risk pregnancies, and is sometimes known as maternal-fetal medicine. Virginia was one of the first people to recognize and inform women about the effect that certain medications or a viral infection could have on their unborn baby.
The potential effect of medications in pregnancy was brought into sharp focus by the thalidomide scandal. In the late 1950s and early 1960s, thalidomide had been given to pregnant women in much of Europe as a treatment for morning sickness and as a sedative. In 1962, its use was linked to 10,000 babies that were born worldwide
with missing or incorrectly formed limbs. It was rapidly withdrawn but its effects left a lifelong legacy for those affected babies and their families, and led to enhanced regulation of drugs. Thalidomide was not licensed in the United States, which was played up by the media at the time as a lucky escape, but the message struck home.
The United States was also undergoing a post-war baby boom and new parents were hungry for information about their babies. Virginia traveled extensively, talking directly to parents and doctors alike. One of her major challenges was infections with the rubella virus, which caused thousands of cases of congenital rubella syndrome—premature delivery, miscarriages, or still births and also newborn heart problems, blindness, and congenital abnormalities, to name but a few. The rubella outbreak in 1964 and 1965 resulted in 20,000 birth defects and 30,000 fetal deaths, propelling Virginia to win funding and government support for a vaccination program.
Virginia was also instrumental in trying to find ways to prevent premature birth, the March of Dimes’ focus since 2003. Her work for the organization, over the fifteen years that she worked with them, is epitomized by one of its slogans that she coined in the 1960s: “Be good to your baby before it is born.” Virginia was always thinking about the needs of mothers, and their focus on their unborn child, and in 1972 she co-authored a book with Joan Beck, entitled IsMy Baby AllRight?. This was one of the first books that explained the causes and treatment of a variety of common birth defects and proposed precautions to help improve a woman’s chances of having a healthy baby. It was an immediate success.
Virginia was an attractive personality, well-liked by all who met her. She was much in demand as a lecturer and traveled the world both for work and pleasure. Her effervescent personality spilled over into her way of speaking, at breakneck speed. Translators found their job impossible but somehow the message got across and audiences responded to her enthusiasm. Her interest in so many activities made her an interesting person to be around and this spilled over into the lecture room where she enriched her medical talks with stories and anecdotes. One of her favorites became known as the Phone Booth Caper.
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“But you loved flowers....”
“No, no,” said the old man. “Don’t attempt to make excuses for me. Your father and mother are dead, Jean. It was my business to replace them as well as I could. Everyone has his obligations. If it is not towards his family, it is towards his neighbor. While I was watering my plants, you were growing up in my house, and I never even noticed it I am only too happy to give you these roses for her whom you have chosen. My life is changed from now on. I have thought more in a few hours than during the last twenty years. In the future, Jean, count on me. I want to help your young household. I have spent my little fortune vainly on my rose-bushes instead of thinking of your welfare.”
“We won’t think about that,” broke in the young man, now overwhelmed with emotion.
“On the contrary, we will think about it,” said his uncle. “Late in the day I am going to be of some use. The autumn roses are often the finest.”
Jean took him in his arms.
“I love you, my dear uncle.”
“To-morrow you will take those bouquets to Le Maupas.”
“We will divide them in two lots, if you agree,” said Jean. “We will put one on my parents’ grave and we will offer the other to Paule.”
“Yes,” agreed the old man, and repeated without knowing it the very words of the younger when he came back from Africa. “We must honor the dead but have faith in life.”
Thus the rose-lover found peace of mind in the ruin of his garden.
CHAPTER X NIOBE’S LAST CHILD
On a dark morning in December a few women slipped like shadows through the snow which deadened their footsteps, to SaintReal and Metropole Streets, which lead to the Cathedral at Chambéry. As one entered the church the half-open door showed the flickering rays of the lamp running along the dark arches. Toward this trembling lamp they hurried, in spite of the cold and the darkness, as though they had come to beg light and warmth from it. Humble housewives, shop-girls, workwomen, servants, they rose early before their work and hastened to the first Mass as though to some secret meeting-place. They came one by one, sometimes recognizing one another in the porch. Already filled with respect for the sanctity of the place, they spoke in low voices. They all joined together in a group constantly growing more and more compact in one of the side chapels, where two candles, which a choir boy was lighting, showed the place of the holy sacrifice. Walking slowly and carefully on account of the frost on the pavement, Madame Guibert allowed herself to be outdistanced by some of the more active women. Nevertheless she was one of the first to enter. She had never forgotten her old habit, always to be ahead of time. She knelt a little to the side and isolated herself in prayer. She had great need of divine help, and begged for it with her whole soul. That very day she was to know the bitterness of being alone. The moment had come for Niobe to give up her youngest child, the one whom she held in her arms and which till now the gods had spared to her. Paule and her husband would leave Chambéry at three o’clock on their journey to Tonkin to rejoin their brothers on the island of Kébao.
The marriage had been celebrated at Cognin in the first days of September Then the young couple had gone to seek solitude among unknown faces in that other part of Savoy, whose matchless
beauty is a miracle of softness, sweetness, and grace—the green plain of Chablais, fringed by the blue waters of Lake Leman and bounded by mountains with their lazy curves wooded to the summit, and further off outlined by rugged peaks which raise their barren whiteness to the blue of the sky and in the evening seem like flagstaffs that reflect on their banners the light of the setting sun. Autumn above all gives this enchanted country its fullest power to stir the emotions. With its blending, dying harmonies it tempers the excessive gaiety which summer lavishes on it; it changes the ringing laughter of water and meadow, plain, and mountain, to that smile of pleasure which knows itself short-lived and yet wishes to rejoice.
Paule and Jean witnessed this autumnal magic. They saw the trees in the woods adorn themselves with a thousand splendid fleeting tints, and the vines which slope down to the shore dress themselves in gold. Their hearts learned the better to appreciate the lesson, already familiar to them, of the insecurity of love when it makes itself its sole end, and, taking the time of a kiss for the time of day, fails to build upon the only sure foundation—a life lived in sympathetic accord and consecrated to the continuity of the race.
They came back to Le Maupas when the vines had been gathered and the meadows harvested, when the brilliance of the sun, the softness of the air, and the grace of the earth increased in proportion to the barrenness round about and strove to detach man from self-centred thoughts. Paule kept very near her mother, as if to forget the threat of the future. And the future cast its shadow upon the present hour which saw mother and daughter reunited. Madame Guibert had been obliged to tell Paule of her wish to stay in Savoy. Jean then generously offered to give up his plans. Monsieur Loigny, his nature decidedly changed, wanted to help his nephew, and at the price of numerous headaches (for he had lost the habit of office work) tried to take stock of the little fortune which he had looked after so badly between two grafts of a rose-bush. He perceived too late that the garden is a bad speculation. Jean’s character and capabilities, Paule’s energy, the financial position of both families, all made them look to the Colonies for the establishment of their new home. Furthermore Étienne multiplied his appeals to them. He told of
the prosperity of his business and was already prepared to guarantee their ultimate success. He begged his sister to bring their mother with her, that in her happy old age she might receive the homage of their filial devotion. Gently but obstinately Madame Guibert had refused.
“I am too old,” she said to Jean and Paule when they insisted. “How should I, who have never gone further than from Cognin to Chambéry and from Chambéry to Cognin, bear such a long journey? I should only be in the way. You will all come home to me in your turn. You will tell me about my grandchildren whom I do not know and whom I love, as I loved my own children before they were born.”
She smiled, so that no one might think of noticing her tears. But she reflected in her heart: “I feel that God is calling me. Now, now at last, my task is finished. I am nearer the dead than the living. When I am alone I will visit my husband more often and my little Thérèse, who are waiting for me in the cemetery. The memory of Marcel, who rests in Africa, will fill my heart. I will make only one journey more, and that will be to find my own again. Those left on earth have no more need of me. From afar I shall pray for them here, and then from above. I can do no more....”
Paule set her wits to work to give her mother daily proof of her love. For so many years she had eaten the bread of sorrow with her. The young wife was inclined to blame herself for her married joy on the eve of this separation, and Madame Guibert had to encourage her to be happy.
“I know what you are thinking about,” said Jean when he saw his wife’s sadness.
“I love you,” she replied. “I love you more than anyone in the whole world, but she ...”
Jean kissed her as he went on: “I am not jealous, Paule, and I understand your trouble so well....”
He had himself arranged for Madame Guibert’s life after their departure. He had installed her for the winter, in spite of her protests, in a little home in the Rue Saint-Real at Chambéry There she would
be less alone than at Le Maupus and would be in welcome proximity to the church.
“I do not wish to be a source of expense,” murmured the poor old lady.
But Étienne in Tonkin had quite agreed with his brother-in-law. And the neighborhood of the Cathedral led to the success of their plan. As the days went on, however, Paule felt her courage weaken while that of Madame Guibert increased. The latter was quite transfigured, and on her forehead with its deep wrinkles, in her clear eyes, on her pale cheeks, the radiancy of her soul shone forth. In the evening she talked to her two children about their future and poured into their hearts her own confidence in God, that confidence which cheerfully leaves to Providence the outcome of one’s own firmness, courage, and virtue.
This teaching, illustrated by her own noble example, they never forgot. Clinging to one another like travelers threatened by a storm, all three tasted the brief happiness of being together and at length sadly reached the morning of their separation. But Jean and Paule were still sleeping when Madame Guibert drew near to God, to find the supreme strength she would presently need.
Suffering souls, who seek in prayer forgetfulness and calm, love to frequent chapels at the hour when day is dying. Under the arches, where the light falling from the windows loses itself, they have a vague consciousness of a mysterious and peaceful presence. One may guess at the state of these stricken beings from the slow murmur of their lips, still more from their weary, hopeless attitudes as they kneel on the softest spots they can find for their knees. But the poor women who go to early Mass have more need of courage than of calm. Before their labors they seek strength and patience in the presence of Him who suffered all human sorrows without a murmur. Hardened by daily work, they do not appreciate a merely comfortable religion, but throw themselves into the faith as into refreshing water, from which they emerge with new life and spirit.
The altar bell had announced the beginning of the holy sacrifice. At one end an aged priest with bent head slowly recited the prayers,
to which a sleepy little clerk made the responses.
Madame Guibert had chosen a dark corner, a little to one side, and was absorbed in her meditations. Her black dress and the widow’s veil that she still wore made her hardly distinguishable from the shadows. She ran over in memory the last days of her life and without difficulty found in them reason to bless and to thank her God. Had He not granted her what she had so long prayed for, in her own misery—the happiness of her daughter? Paule, her little Paule, not only the best beloved of all her children, but the most loving, and the support of her sad old age—how often had she called down divine blessings upon her, whom the family sorrows had most intimately touched. Doubtless in bestowing them, God would tear her heart. But since this was the necessary price, how could she have the cowardice to murmur against His beneficent Will or to hate the loneliness which was coming upon her that night?
“No, no,” she said in her prayer. “I will not pity myself, as we are so often tempted to do to excuse our weakness. My God, Thou wilt aid me in my need. I will be firm to-night. They shall not see me cry. I could not go with them. Thou hast warned me of my failing strength, and my work is done. My children will carry it on better than I could. I thank Thee for having in Thy goodness allowed me to see my daughter’s happiness. I entrust her to Thy protection during this long journey with her husband who has become my son.” All shaken with emotion she added: “I entrust to Thee, my God, yet another life, dark and uncertain, that of a little babe still to come, whom my hands will never receive in this world. Grant him health, intelligence, a firm spirit, and submission to Thy holy law. Grant him a long life in order that he may be able to serve Thee better May he be strong and brave in well-doing, may he fear neither laughter nor tears, may he love work, and may he be to his mother what she has been to me.”
Some time before the happy Paule had told her of her dearest hope, which was confirmed as time went on. Her marriage was already blest. A new source of love and devotion had welled up in her.
When Madame Guibert lifted her head which she had hidden in her hands, she noticed that the priest was leaving the altar and she reproached herself.
“I have not heard Mass.” But she immediately felt reassured, for in her prayer she had found the peace she sought.
From here, from there, from chair and bench, one by one the congregation rose and went to the door. They were going to their daily work with quiet hearts and bodies prepared. In her turn Madame Guibert left the church. Outside day was scarcely breaking over the snow on the roofs and streets—that sad winter’s day which would see her come back from the station alone.
She turned the key in the lock and on tip-toe crossed the passage full of trunks to go to the kitchen noiselessly. Old Marie was already preparing breakfast.
“Monsieur has just gone out to engage the omnibus,” she explained.
“Without any breakfast?” asked Madame Guibert, thoughtful as ever.
“He did not wish any. He just said he would not wait.”
“And Madame?”
“Madame who? Oh yes, Mademoiselle Paule! I cannot get used to calling her Madame. It’s funny, isn’t it? Mademoiselle is still asleep. There I go again, the same mistake. When one is old, one is good for nothing.”
“It can’t be helped, my poor Marie, we are both old.”
But both of them, paying little heed to what they were saying, were thinking of the parting to come. The servant, taking off her spectacles, passed her rough hand over her eyes. With her shaking fingers Madame Guibert tried to make Paule’s chocolate for the last time. She made it the way she knew her girl liked it. Then she listened at the door, knocked softly, went in, and found Paule in tears.
“Mother, mother! Tell me that I must go. I have not the strength myself to say it.”
Madame Guibert put the steaming cup on the bedside table, then she laid her wrinkled hand on her daughter’s forehead.
“Dear little one,” she said, “I wanted to wait on you myself this morning, and I ordered these rolls that you like so much.” She bent over her and in a low voice, as she kissed her, murmured: “Be brave, Paule. It is God’s wish. Your husband’s love assures me that you will be happy. And do not be alarmed about me.”
But their tears still flowed. Jean came back and saw the two women locked in each other’s arms. He thought that Paule was trying to comfort her mother.
“We will come back, Mother,” he said. “We will come back, I swear it. Next year you will have Étienne and his wife and in two years you will see us.”
But when Madame Guibert turned to him, he saw with surprise that she was not crying and that the consolations came from her, not Paule.
“In two years,” she thought, “where shall I be?” But she answered gravely: “Jean, love your wife dearly. When you are far from me, that thought will be my strength. God is so good and watches over us. We shall be more closely united than ever when we are separated. Our thoughts and our hearts will be one. Distance is nothing when one is sure of love.”
With a solemnity that came quite naturally to her and affected her voice quite unconsciously, she went on: “You must love each other. Don’t make of your love a source of weakness. Gather from it and your mutual confidence more resolution, more courage in life. Look ahead of you. When you look behind you, towards our dead and towards me, may it not be to find discouragement there, but to understand your own youth better, and all that God expects from it.”
Jean and his wife had taken her hands and were listening to her without interruption.
“Yes,” she continued, as if she were unfolding the future, “look before you, towards your work, towards the family that will come after you. Give your sons and daughters brave souls and make them look ahead in their turn, with eyes in which your past will have shaped their outlook.”
They were both weeping, while she remained peaceful and calm.
“My blessing is on you,” she concluded. “On you, my little Paule, for your loving daughterly goodness to me and your devotion to your brothers. On you, Jean, for the friendship you have shown to Marcel and for all the happiness that I see in your eyes, in spite of the tears.”
Her firmness did not break down till the moment of departure. She cheered her tearful daughter in the name of the little one whom the young wife carried under her heart. But Paule could not resign herself. She kept on kissing her, hastened to speak again, and sometimes turned towards her husband to say to him: “I love you, dear, all the same; you know that.”
Madame Guibert insisted on going to the station with them. There they found several friends, who had come to say good-bye. M. Loigny was ill and had not been able to come out on account of the cold and the damp roads, but his Fanchette brought for his niece some hothouse flowers. Some distance away Madame de Marthenay, looking quite thin in spite of her furs and very pale, was watching a favorable moment to kiss Paule. The latter noticed her and came up to her. After a second’s hesitation the two women threw themselves into each other’s arms.
“Still unhappy?” Paule asked gently, reading the sorrow in her old friend’s face.
“Still. But what of you, Paule?”
They both turned to Madame Guibert. Very quickly Madame Berlier murmured: “Do you want to do me a great kindness, Alice? Go to see Mother often, look after her a little, and write to me about her health.”
“I promise you I will,” said Alice with deep emotion as they parted. Soon after Madame Guibert was left alone with her daughter and her son-in-law. As before, her last words at the moment of separation were a prayer: “May God keep you!” But when the train had carried them out of sight she touched her forehead and felt that it was icycold.
“It was time, my God,” she thought. “I had no more strength left.” She was forced to sit down in the third class waiting-room. The passengers who came and went, occupied with their luggage and their tickets, did not even notice the poor old woman in mourning who sat sobbing there. She had become a humble weak creature again. But she had had the strength to hide her suffering from her children.
Alone in the railway carriage with his beloved, Jean pressed her to his breast. She had quite broken down and her head leaned against the heart which beat for her only. He said nothing to her, knowing the uselessness of words. He gently stroked her cheek and from time to time bent down to kiss the eyes whose tears he could not stop. When she raised her head a little he comforted her by saying: “We will come back, Paule.” She shook her head, doubtful of this return, or because she did not yet wish to be consoled.
“I love you, Jean,” she sighed, and began to weep afresh.
Then he spoke to her of her mother
“Paule, she is setting us a splendid example of heroism and selfsacrifice. May we never forget it! And if later on, in many years to come, we have occasion to imitate her may her memory still be present with us. Oh, may the child who is coming to us be like her!”
Paule was listening to him more calmly, and he added: “May God protect both our child and her whom we have left behind with a broken heart!”
“Yes, I will pray,” she said. “It was God who gave my mother the resignation that she tried to implant in me.”
In her young life, she had known many hours of anguish and mourning; but she had never known a more painful one than this.
She thought she tasted the bitterness of death, yet in reality her life was stirring to its inmost depths. Her love was purified, all unknown to her, in that divine flame of maternal sacrifice of which she was more and more to appreciate the value.
As the railway passed in front of the oak wood which is neighbor to Le Maupas, Jean and Paule looked at the familiar landscape through the window. The tree-branches bore snowflakes for leaves, their whiteness tinted by the setting sun. On the vine-row hung a lacework of frost.
Here it was, and here alone, that Paule had learned to know life, death, and love. She thought of the proud, passionate, young girl, whose boast was the care with which she watched over her mother.
“Kiss me,” she cried to her husband. “I have so much need of love to be able to go away from here!”
Jean took her in his arms. And the kiss they gave each other spread a sacred thrill through their veins; for to that union of their body and soul they added the filial devotion of the past and that mysterious hope for the future which made their lives so much fuller and gave an immortal meaning to their love.
CHAPTER XI PEACE
Madame Guibert rose with difficulty from the bench on which she had seated herself to weep. She saw a few strangers passing hurriedly and wished to hide her sorrow
“I cannot stay here any longer,” she thought When she stood up she had to hold on to the wall and she wondered if she would have the strength to reach the house.
She felt her age and her weakness hanging like heavy weights on her shoulders. She remembered the day when she dragged herself through the endless chestnut avenue at La Chênaie. On the threshold of the station she thought anxiously of the long road home. But accustomed as she was to spend nothing on herself she did not dream of hiring one of the cabs in the Square.
She set out slowly, leaning on the umbrella which served her as a stick and putting her feet down carefully so as not to slip on the snow. The hardships of her journey made her forget her sorrow, but when she stopped a moment she whispered gently the name of Paule—of Paule who would never, never be her help again. Her mind was following the two dear ones who were carrying away with them all her happiness.
“They have reached the waterfall at Coux now.... O God!”
As she was crossing the bridge over the muddy waters of the Leysse she stopped and leaned on the parapet to take breath. At that moment she heard someone call. “Madame Guibert,” said the voice, “will you allow me to come with you?” It was Madame de Marthenay, who had watched her from the station, hesitating between the wish to help her, according to the promise she had
made to Paule, and the fear of breaking in upon her absorbing sorrow. Seeing her now in distress, she came forward.
Madame Guibert was so tired that she took the arm offered to her. In her sorrow she hardly spoke during the walk home. Alice, with tactful delicacy, tried to console her in talking of the joy her children would have when they saw her again. On the doorstep Paule’s mother thanked her gratefully.
“But I am going to help you upstairs,” Madame de Marthenay insisted.
“You are very kind. Thank you very much.” And when they were at the head of the stairs she added: “Come in for a minute. You must rest a little. I leaned very heavily on your arm along the road.” The poor weary eyes in their appeal laid bare the tragedy of the desolate home.
“I shall be very glad,” said Alice, moved to deep sympathy as she followed the old lady into a bedroom, changed by means of a screen into a little sitting-room by day. Marie the maid, still overwhelmed by “Mademoiselle’s” departure, brought in a telegram.
“Here is a message,” she said, with a hostile glance at the elegant Madame de Marthenay.
With difficulty, and shaking all over, Madame Guibert tore open the envelope. She could never open one of those little blue papers without trembling for they might have a message of death in them. But her face cleared immediately. As she read, Alice was looking round her mechanically at the simple and modest, almost conventional, furniture. Her eyes fell on the enlarged photograph of Marcel. She went up to it. The Commander wore his disdainful, impassive air in the picture, which dated from his return from the Sahara.
Madame Guibert turned round and saw her contemplating her son’s photograph. She regretted having brought her into the room. But as she went up to her, Alice looked at her and burst into tears.
“What is the matter?” asked Madame Guibert.
“Oh! Madame, Madame!” cried the young woman, and she sobbed out her secret to Marcel’s mother. “I loved him! If only you knew how I loved him!”
In profound pity, Madame Guibert gazed on the woman who had given her son his distaste for life. She knew from Paule that at the time of Marcel’s death the photograph of a little girl had been found in the breast-pocket of his tunic. Of a “little girl” indeed! How true it was that he had set his affections on a child.
“Poor little one,” she said, stroking Alice’s cheek as she sat drooping in a chair In face of this sorrow waiting to be consoled, she forgot her own misery and immediately recovered her presence of mind and her courage.
“Alice, my dear, calm yourself,” she repeated. But Madame de Marthenay still sobbed. She finished with those words which she had uttered already, the words which summed up her distress: “Why am I not his widow? I should be less miserable.”
“But you did not wish to be his wife,” Madame Guibert murmured gently.
“Oh yes, I did, for I loved him. It was my people.” She did not accuse her mother only. But the old lady shook her head and in a lower voice she said, quite close to her ear, as she continued to stroke her cheek: “Poor little girl—you did not know how to love.”
Alice attempted to protest.
“No,” repeated Madame Guibert, “you did not know how to love. When you give your heart it is for ever And love gives you strength and patience and endurance. Your mother was seeking your happiness, dear, but she was seeking it in her own way. She thought she was acting right when she turned you from my son. Don’t blame her, only blame yourself. There was no doubt that Madame Dulaurens would have yielded in the long run, to a real affection, because she loved you and would have seen the object of your love to be worthy of her approval.” She did not notice that she had drawn away her hand, and under the influence of the past she reiterated: “No, you did not want to be Marcel’s wife.”
Alice was quite crushed and could only whisper, “I love him still.” Distractedly she clung to her fruitless love.
In a firmer voice Madame Guibert went on: “You were afraid of life. Your parents were afraid for you. Life, Alice, does not mean just amusement and worldly excitement. To live means to feel one’s soul, all one’s soul. It means to love, to love with all one’s strength, always, to the end, and even to the point of sacrifice. You must not fear either suffering or great joy or great sorrow. They reveal our higher nature. We must take from the fleeting days the happiness that endures. The girl who marries comes to share in work and danger, not just to seek greater ease or more frivolous pleasures. In her very devotion she will find more delight. You do not know this.”
Alice, encouraged, thought as she listened attentively, “Nobody ever talked to me like this before.”
“Even now,” went on Madame Guibert, “even in this hour when my heart is broken, I can only thank God who has heaped His blessing on me. It surprises you, my dear, that I can talk of my happiness to you to-day. It is true nevertheless. I am happy. If God asked me to begin my life all over again, I would do so. And yet, I have seen the dearest faces cold and still, and I have known the cruellest form of death for a mother—that which strikes her child far away. But through my husband, through my sons and daughters, I realised all my heart and what may come upon us by the divine goodness. My life has been quite full, since it was mixed with theirs. Now I am no longer alone. My beloved dead keep me company and the living do not desert me. Look at this telegram I have had from Étienne. He knows that Paule has left me to-day and he is comforting me in the name of them all. I had need of it!”
“Madame!” whispered Alice, kissing her hand.
“Yes, my dear, I have loved my life, I have loved life itself. And I can die, even alone, even if strange hands close my eyes. God has made my lot a very beautiful one and death will find me obedient and resigned.” Her clear eyes shone with a holy ecstasy.
Alice, her heart at peace, looked at her respectfully and admiringly.
“Go on talking to me,” she begged as Madame Guibert was silent.
The latter looked at her long and tenderly, then again stroking her cheek, she said:
“My child, you must promise me something.”
“Oh, Madame, I will promise you anything you like.”
“Try not to think about Marcel. You have no more right to. Accept your new life, as it is, without any regrets. God expects you to be brave enough to give up all your old dreams. You were wrong to make your husband change his career. Work is the true nobility of life. Help him to find some work, and atone for your mistake.”
“He has deserted me, Madame Guibert.”
“Idleness was perhaps the reason for that. Try to forgive him. Put your heart into your advice. Let him look after his estate, or interest himself in the affairs of the town. You will see that all is for the best. You may still be happy. Your daughter will help you. Is a woman ever to be pitied who has a child? Prepare this young life to be virtuous and strong. Love her, not for yourself but for herself. And God’s peace will rest on you.”
“Oh, if you would only have me here sometimes and talk to me,” said Alice eagerly, “I think I should take heart once more.” She never seemed to think that her presence might recall a painful memory to Madame Guibert. But it was only for a moment that the latter hesitated.
“Come here whenever you want me,” she answered simply.
When Madame de Marthenay had gone, Madame Guibert took Marcel’s photograph and placed it beside her bed, behind the screen.
“He will be nearer to me,” she thought. “And Alice will not see him again. She must not see his face if she is to do her duty bravely.”
Then she knelt and prayed:
“My God, Thou who art my strength, help me. I have now given up to Thee all that I have loved. I have nothing left to offer Thee but my sorrow. Accept it, and protect all my dear ones—the dead who rest and the living who are at work....”
When she rose to help Marie lay her modest table, her face glowed with a serene peace—the peace of those who wait fearlessly for death after having met life bravely.
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FEAR OF LIVING
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